Left Behind No break for the wounded

A roadside bomb hit Sgt. Jerrald Jensen's Humvee in Iraq, punching through heavy armor and shooting a chunk of hot metal into his head at several times the speed of sound, shattering his face and putting him in a coma. "I wasn't supposed to live," the veteran lisped with half a tongue through numb lips. "No one knows why I did. It's shocking." Even more shocking is what Jensen did next. After 16 surgeries, the sergeant volunteered to go back to combat in one of the most savage corners of Afghanistan, where he was injured again. Perhaps most shocking, though, is what happened when he got home.

Jensen returned to recover in a battalion at Fort Carson designed to care for wounded soldiers called the Warrior Transition Unit. In the WTU, the soldier with a heroic record said he encountered a hostile environment where commanders, some of whom had never deployed, harassed and punished the wounded for the slightest misstep while making them wait many weeks for critical medical care and sometimes canceling care altogether.

In 2011, a year after joining the WTU, just days after coming out of a surgery, Jensen tested positive for the drug amphetamine. The then-41-year-old asked to be retested, suggesting his many Army prescriptions might be to blame. His commander refused and instead gave Jensen the maximum punishment, cutting his rank to private, docking his pay and canceling surgery to fix his face so he could spend weeks mopping floors, picking weeds and scrubbing toilets.

Then, Jensen said, WTU leaders said he should be discharged for misconduct — the equivalent of getting fired — with an other-than-honorable rating that could bar him from medical benefits for life.

"To call guys who sacrificed so much dishonorable and kick them out with nothing?" said Jensen, who is now out of the Army, living in a small apartment with blankets covering the windows because his injuries make him sensitive to light. "Christ sake, man, it is a disgrace."

With troops going back and forth between duty stateside and in war zones during multiple deployments, disciplinary regulations designed for more conventional wars of the past increasingly are snaring troops. A Gazette investigation shows that after a decade of war, the Army is discharging more soldiers for misconduct every year. The number kicked out Army-wide annually has increased 60 percent since 2006.

Sunday, The Gazette detailed how some of the discharged have invisible wounds of traumatic brain injury and post-traumatic stress disorder but are kicked out anyway. The factors driving the surge in discharges include a lack of objective tests for those invisible injuries; the need to shrink the force by at least 80,000 by 2017; and Army systems that make combat units wait months or years for replacements for the wounded, turning injured soldiers into a burden and giving low-level leaders incentive to get rid of them.

"At a policy level the Army is saying it takes care of these guys but at a command level it is not happening," said Lenore Warger, a counselor who has worked with discharged soldiers for 12 years at the veterans rights organization The Quaker House near Fort Bragg in North Carolina. "Oftentimes guys with PTSD or TBI are shunned. Instead of being cared for they are marginalized."

More than 13,000 soldiers were discharged for misconduct from the Army in 2012, records obtained through the Freedom of Information Act show. Army leaders contend that caring for soldiers is a top priority and no one is unduly punished. But the Army does not track how many of the discharged were also injured.

A struggle for justice

Jensen's saga shows that in the recent surge of misconduct discharges, wounded soldiers are targeted even when injuries are obvious, conduct is heroic, alleged misconduct is relatively minor, and the unit punishing them is designed to help troops heal.

"If it can happen to me, it can happen to anybody," Jensen said.

The Army refused multiple requests to comment on Jensen's case.

Army regulations allow soldiers to be discharged for any number of infractions, from drug use to disrespect to showing up late too often. Ultimately, the commanding general of each post decides who is punished and who is spared.

Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, said the Army considers soldiers' entire records, as well as their physical and mental conditions, in a discharge. "In short, each case is considered individually and judged on its merits," he said in an email.

At Fort Carson, discharge data obtained by The Gazette shows few of the wounded are spared. Of the 41 Fort Carson soldiers designated as wounded (those in the medical discharge process) who were targeted for a misconduct discharge in 2012, 80 percent were cut loose.

In the WTU, where soldiers by definition have complex medical issues, the rate of discharge was just as high. Of the five soldiers up for punishment, all but one were kicked out.

In 2011, it was even more harsh. Of four WTU soldiers targeted for misconduct, all were kicked out.

The Fort Carson figures do not account for the unknown number of soldiers with PTSD or TBI who are not in the medical discharge process or the WTU. The Army said it does not track the number of wounded soldiers kicked out for misconduct.

Maj. Gen. Joseph Anderson, who commanded Fort Carson from November 2011 until mid-March and is slated to become commander of Fort Bragg this summer, said discipline must be strictly enforced, even when soldiers are hurt.

"You are still a soldier until you take the uniform off," he said. "So you cut your hair, you don't smoke pot, you take care of yourself, you don't tell people to F off, you don't get DUIs, you don't go smoke spice."

Jensen agreed but said when some soldiers struggle from injuries sustained while serving, the country should not abandon them.

"We are not asking for much. The Army owes us what we owe the Army. Fulfill the contract. Simple as that," he said. "We went over there. We served honorably. We were hurt in the line of duty. We should be taken care of."

Honor and service

Jensen was raised in part by his grandfather, Walter Hinkle. Walt, as Jensen called him, was a Marine captured by the Japanese in World War II who survived the Bataan Death March and three years in a prison camp then stayed in the Marines another 25 years, through the Korean War and part of the Vietnam War.

"He taught me everything I know about honor and service. Everything. I wanted to be just like him," Jensen said.

When the twin towers came down in 2001, Jensen, a wiry, 5-foot-6 31-year-old working in construction, called his mother and told her he had spoken to his grandfather. Walt had said, "Put your life in order; it is time to serve your country."

"I said, 'Honey, Walt has been dead for some time,' " recalled his mother, Annie Rees. "He said, 'I know, but I spoke to him, and he said it was time to go.' "

Jensen joined the Army in 2004. He was assigned to the 3rd Squadron, 61st Cavalry Regiment, based at Fort Carson in late 2005 and soon deployed to the most dangerous part of Iraq during one of the most dangerous times of the war.

It was Baghdad, late 2006. At the start of the war, the Pentagon assured the public that troops would be greeted as liberators. By the time Jensen arrived, Muslim factions were battling for control using market bombings and murder squads, and troop deaths were on their way to an all-time high.

Just as the outlook had changed since the invasion, so had the trucks. At the start of the war, soldiers drove lightweight, doorless Humvees. Insurgents kept hitting them with roadside bombs, so the Army covered the trucks in armor. Insurgents responded with bigger bombs, so the Army added more armor.

By the time Jensen was driving the streets of Baghdad, his Humvee was encased in steel and blast-proof glass. The enemy responded with a vicious little device called an explosively formed penetrator, or EFP.

An EFP is a piece of steel pipe, no bigger than a paint can, packed with explosives and capped with a bowl-shaped copper disk. When the explosives fire, the copper instantly warps into a molten dart flying at five times the speed of sound. It can slice through armor like a knife through butter.

No place safe

In the first few months Jensen was in Iraq, EFP attacks more than doubled.

Insurgents set the explosives where traffic had to slow, aiming the copper spears at the front windows where senior leaders often rode.

Soldiers tried to look out for them, but there was little they could do.

"We lost a lot of guys that way," Jensen said. "There was no neighborhood that was really safe."

Jensen was the driver for the No. 2 commander in his battalion, a hard-working major named Keith Brace. Their mission was to drive the most dangerous neighborhoods every day, trying to forge alliances with local leaders.

Over the months, the major and Jensen grew close. "Jensen was a great guy," said Brace, now retired. "Very talkative, active, high energy. ... I always got the feeling he was taking good care of me."

In August 2007, the Army received intelligence that insurgents were targeting the top commanders in his battalion, Jensen said. He figured the insurgents probably knew the major always rode in the front passenger seat, and one well-aimed EFP would cut him in half.

On their next rest day, Jensen had Army welders move the major's seat back 6 inches. Jensen figured that if an EFP hit, the blast might still rip off the major's legs, but at least he might live.

Three days later, on Aug. 22, 2007, it happened. They were rolling in a convoy of six Humvees through a rough neighborhood on the edge of Sadr City. Jensen drove while a gunner on top of the Humvee scanned the rooftops and the major talked on the radio in his pushed-back seat.

The convoy slowed to go through a gate. On one side, sun-bleached buildings lined the road. On the other, a dusty soccer field rippled in the heat.

"It was a good day," Brace said. "Everything was normal. Kids were playing soccer. You don't see people out if a bomb is about to go off."

Jensen watched the trucks in front of him creep through the gate, unaware that three EFPs were cached on a concrete barrier on the roadside.

Then, boom.

'This isn't good'

The EFPs slammed into Jensen's truck and a molten plume pierced the passenger door, spraying shards of armor as it shot across the seat. It missed the major's head by inches, taking off two of his fingers, then slammed into the truck's radio and exploded.

Jagged metal tore into the gunner. A piece of metal pierced Jensen's knee. Another shot through his head, just in front of the ear, shattering his jaw and breaking the front of his skull in several places. The force blew chunks of his cheeks, pallet and sinuses out through his mouth.

It all happened before Jensen heard the blast.

There was a deafening bang. Silence. Ringing. Coughing. Confusion. Smoke and dust and the odd, indelible details that stand out in catastrophes. Light was shining through the truck where there should not be light. The engine was running.

Jensen's awareness materialized in the fog, and he checked himself: two arms and two legs, some blood, but not too much. He saw the major slumped over, maybe dead.

Jensen knew EFPs often came with secondary blasts and snipers to pick off the survivors. Get out of the kill zone, he told himself.

He slammed on the gas, and the truck bounced off the road, through a fence and onto the soccer field. He pulled behind a low concrete wall that offered some cover. Machine-gun fire ripped over the field.

Jensen noticed a blotch of blood spreading on his pants. He pulled a pressure dressing from his pocket and went to rip the wrapper off with his teeth only to find his whole hand sinking into the bloody wreckage of his face.

"This isn't good," Jensen said to himself. "But I have my arms. I have at least one good leg. I can fight."

He grabbed his rifle and lurched out of the truck.

Within moments, he was shot. The bullet hit his right arm, shattering his elbow and punching out through his back.

He slid down the side of the truck. As he lay back, the pulp of his face settled in his throat and choked off his breath. Here, he thought, is where I will die.

A medic appeared over him and shoved a breathing tube down his throat. "You're hit bad," Jensen remembers the medic saying as he worked. "Your leg, your arm, your face. I'm giving you some morphine."

Jensen nodded. A few moments later, he was out.

Advances create problems

Few people expected Jensen to wake up. And if he did, they did not expect him to still be Jerry Jensen. But battlefield medicine has made unprecedented advances in the past decade.

In World War II, about 60 percent of soldiers who were wounded survived. In Vietnam, the rate improved to 70 percent. Now it's about 95 percent, the Army's Combat Casualty Care Research Program said.

"People are surviving who never would have in the past," said Col. Dallas Hack, the program's director. "That creates a whole other set of issues."

These soldiers require complex recovery that can take years. While they are mending, they remain on active duty, under the same strict rules as healthy soldiers, even though many struggle with addiction to medicines, psychological trauma and the behavioral issues both can create.

A helicopter whisked Jensen from the soccer field to a hospital where he was stabilized and flown to another hospital in Germany. As he lay unconscious, his brain began to swell, and he started having seizures and slipped into a coma.

Covered in bandages and dried blood, he arrived a few weeks later at Brooke Army Medical Center in San Antonio, where the Army treats its most serious trauma cases.

His wife, uncle and mother met him there.

Jensen was so deformed that his mother didn't recognize him. His head was grotesquely swollen. Metal scaffolding held his shattered arm. Tubes ran from his arms, throat, chest and belly. His eyes were stitched shut, she said, so they would not split from the swelling. His face was a collision of wounds kept open to drain.

Surveying the damage, his mother, a Mormon bail bond agent from Nevada, turned to a chaplain and said, "Get every chaplain you can. Muslim, Jew, Catholic, Baptist, I don't care. I want constant prayer over this boy."

Jensen was kept in a medically induced coma for about two months. A few times, the doctors tried to slowly bring him out, but he would thrash uncontrollably, crashing against bed rails and punching at the staff until doctors sedated him again.

"It was like he was still grabbing for his gun, like he still thought he was in the fight," his mother said.

Privacy laws prevent the Army from discussing his treatment.

Ten weeks after the blast, Jensen's mother said, she persuaded the hospital to let her son wake up.

The first thing Jensen remembers is the voice of a doctor talking to his mother and wife.

"Jerry seems to be waking up," the voice said. "We don't know how coherent he'll be. We don't know if he will ever be more than a vegetable."

Hey, wait a minute, Jensen wanted to tell them. I'm right here. I can understand everything.

But his arms were bound. His mouth was destroyed. A hole cut in his throat kept him from even grunting. So he expressed his disagreement in the only way he could.

He raised a trembling finger and gave the doctor the bird.

'True excellence'

The next day, Jensen said, he was walking on wobbly legs.

Two days later, he left intensive care.

There was a long recovery ahead. Parts of his lips were gone. His jaw was floating fragments. His sinuses were scarred wreckage.

In the next two years, he said, he had 16 surgeries. He got a new jaw cobbled together with titanium. He got a new top lip formed from skin cut from his chest. He got a new bottom lip formed from a piece of his tongue.

With each new procedure, Jensen remembered his grandfather's hard road.

"I felt lucky. Another inch and that blast would have gone through my brain. Yeah, I was blown to pieces, but I was alive," he said.

Jensen was assigned to the Warrior Transition Unit at the hospital, a unit whose mission was to help him coordinate his care and get to appointments. He said the treatment was excellent.

Jensen's doctors marveled at his progress. Then, in 2008, he said something that really astounded them: He wanted to go back to his combat unit.

The medical team said it would take 18 months to finish his surgeries and heal. His battalion had orders to deploy to the mountains of Afghanistan in 18 months.

"I knew it was going to be a tough fight," Jensen said. "I knew they needed everybody. I was going to be scarred up after the hospital, but I was OK. I wanted to help."

Jensen said the lead doctor told him he was healing well. When the time comes, if you are medically ready, there is no reason why you can't go, Jensen remembers him saying.

The top sergeant of his battalion agreed, he said. If the soldier was healthy enough to do the job, why not?

Maj. Brace was recovering in the same hospital.

When Jensen first woke up, Brace came to his room in a wheelchair and thanked him for saving his life. "You have given me the opportunity to walk my daughter down the aisle someday," he said.

When he heard Jensen wanted to deploy to Afghanistan, he visited him again.

"All of us have that urge to get back to the unit," Brace remembers saying. "You don't have to do this. Get yourself healthy."

"No," Jensen replied. "I'm ready now."

Jensen arrived for training late in 2008 at Fort Carson with a feeding tube still in his belly and the tip of a tracheostomy tube poking above his uniform collar. Six months later, he left for Afghanistan.

Brace is now an instructor at The Citadel in South Carolina where he instructs future officers. He keeps a photo of Jensen in Afghanistan on his office wall and often tells his story to cadets so they will understand what he called "true excellence."

"I take great pride in his courage, his toughness, his dedication, his patriotism," Brace said. "Our country should feel good knowing people like him serve."

Return to duty

In May 2009, Jensen ended up in Kunar, Afghanistan. The tiers of remote, lawless mountains along the Pakistan border had been a refuge for Osama bin Laden at the start of the war and almost a decade later still burned with resistance.

Jensen was given light duty, manning the armory at a base, but the sergeant quickly proved that he had a cool head, a strong heart, and a tight bond with soldiers. As casualties mounted, the unit needed replacements. Jensen was put in charge of an infantry team at a forsaken observation post on the crest of a mountain.

Just weeks before Jensen's team took over, the remote sandbag post was attacked by more than 100 enemy fighters who burned it to the ground, killing every American there.

Officially, the outpost was named Bari Alai, but the team started calling it "Barely Alive."

Jensen's team rebuilt the outpost from its ashes, stringing razor wire and filling sandbags by hand.

The only way out was by helicopter. Isolated from the comforts of big bases with fast food and Facebook, the troops lived in a different world. They slept on the ground and ate meals in the rain. They had a pet monkey until the monkey bit an Afghan National Army soldier serving with them and, Jensen said, the Afghan soldiers ate the monkey for breakfast.

Insurgents tested the outpost constantly. It was attacked 222 days of the 365 days the battalion was there.

"They kept trying to overrun our position, but we held them off," Jensen said.

For his efforts, Jensen was recommended for promotion by his superiors, who wrote in an evaluation in September 2009 that he had "honor and integrity above reproach," "epitomized selfless service" and "displayed outstanding personal courage."

In October 2009, six months after retaking Bari Alai, Jensen was running to a gun position when he tripped over a rock and fell, cracking his kneecap and re-breaking several bones in his face. He got up and kept soldiering, hopping around the outpost on crutches.

A week later, while on a supply run at the main base, he said, he helped stabilize wounded comrades coming off helicopters after nearby Combat Outpost Keating was destroyed by the Taliban, killing eight soldiers and wounding 22.

Two weeks later, Jensen went home on mid-tour leave and discovered his broken jaw was badly infected and needed to be rebuilt. The Army would not let him go back to Bari Alai.

Jensen was crushed. He kept dwelling on whether the young soldiers in his outpost would be OK.

"I love the people I serve with," he said, remembering how he took the news. "I was honored for those guys to trust me with their lives.

"I know they were honored for me to trust them with mine."

'A big mistake'

The titanium in Jensen's jaw was broken. His face was badly inflamed. Doctors said it would take another two years of surgeries to repair. Jensen could not stay in his combat unit, so he transferred to Fort Carson's Warrior Transition Unit.

"It turned out to be a big mistake," he said.

The Department of Defense created WTUs in 2007 as a way to ensure soldiers with serious medical problems got good care without impeding combat units. To get in, soldiers had to demonstrate a need for at least six months of complex medical care.

The Army hailed the WTUs as a step forward, but before long some soldiers claimed that the units became a dumping ground for troubled soldiers where suicide and drug abuse lurked in the ranks.

In April 2010, a month after Jensen joined, the New York Times published an exposé of the dysfunction at Fort Carson's WTU, calling it a "warehouse of despair, where damaged men and women are kept out of sight, fed a diet of powerful prescription pills and treated harshly by noncommissioned officers."

As the Army scrambled to respond, Jensen volunteered to stand up at a news conference with Col. Jimmie Keenan, then head of Medical Command at Fort Carson, and defend the WTU.

Jensen had been in Brooke Army Hospital's WTU and said it helped him recover.

"If it wasn't for them," he told the news cameras, "I would not have been able to return to duty, which was my ultimate goal."

Looking back, he shook his head.

"I had seen the WTU work," he said. "I knew it could work here. Commanders just needed to realize they are not just pushing tin; they are dealing with wounded people that need to heal."

It didn't happen, he said.

In the WTU, Jensen, too, began getting treated harshly by sergeants and punished for minor missteps, he said. He did not wake up for formation once because of an infection in his damaged sinuses and was written up. He was late to a medical appointment and was written up. He got a ticket for rolling through a stop sign and was written up, he said.

The Army would not release information on his misconduct.

"Just because soldiers are in the WTU doesn't mean they have a separate standard," said Col. John McGrath, head of Medical Command at Fort Carson, when asked about Jensen. "We have to maintain good order and discipline."

Little empathy

The Fort Carson WTU would nitpick soldiers but did not apply the same strict standards in providing care, Jensen said.

One night in October 2011, he went to the civilian emergency room for numbness in his extremities, and a CAT scan revealed problems with his spine. The hospital said the issue could cause paralysis, and Jensen needed to see a neurologist within 72 hours. The WTU told Jensen it would take six weeks, he said.

Jensen's wife, Robin, was furious. She called the WTU screaming, he said. In response, commanders said his wife was unstable and obviously on drugs. They wrote him up for being unable to control her, he said, then put him in the barracks and forbid him from seeing his wife until she checked into a psychiatric hospital.

Fort Carson denied requests to interview Col. Mechelle Tuttle, who commanded the WTU until mid-April. Jensen bypassed his chain of command and appealed to the head of the hospital at the time, Col. Keenan.

Keenan remembered him as the soldier who had stood up for the WTU and made sure he immediately saw a neurologist and ordered the unit to let him see his wife, he said, but the interference made his immediate commanders angry.

"You think you're special," Jensen said his first sergeant told him, slamming a book down in front of him. "I'll kick your ass even if you are 100 percent (disabled)."

Fort Carson denied requests to interview the first sergeant, Barry White.

Several soldiers in the WTU interviewed by The Gazette said commanders had little empathy.

"They fail to realize what guys are going through, because none of them has ever set foot in another country," said Matt Bessler, a nine-tour retired Special Forces sergeant with three bronze stars who was in the WTU with Jensen for PTSD. "They should be helping. I just don't think they get it."

A 2012 Army investigation of the WTU at Fort Bliss obtained by KTVT news in Texas found similar problems, noting the command climate in the WTU was "toxic." Soldiers reported the "primary attitude" of superiors was "punitive, like a correctional facility." The report said sergeants viewed the WTU as a dead-end assignment and "a thorn in the side of the Army." Some of them dealt harshly with the wounded.

One wounded soldier who propped open a door near his room that was supposed to remain closed was forced as punishment to sit by the door with his service dog for 11 days, the report said.

In January 2012, Jensen, 41, went in for a routine drug test and flagged positive for amphetamines.

"I was stunned; it had to be a mistake," Jensen said.

He was taking pseudoephedrine for his damaged sinuses, as well as narcotic pain drugs. He said he had also been helping his terminally ill father use an amphetamine-based albuterol inhaler.

"Maybe that caused a false positive," he said. "I asked them to retest it, but they never did."

Pseudoephedrine and albuterol can cause a false positive on initial drug screenings, said a spokeswoman for the University of Colorado medical school, which teaches toxicology. A second test is needed to rule out false positives, she said. Jensen said his Army lawyer asked repeatedly to see the test paperwork, and Fort Carson did not provide it.

"Instead, they just told me they were kicking me out," he said.

The commanders said the test was "overwhelming evidence" Jensen was a drug abuser.

For years, Jensen's mother was a parole officer trained in detecting drug use. When she heard about her son's positive test, she went to his house to investigate.

"I checked all his cupboards and bathrooms. I went through everything," she said. "You can smell meth. I'd know that smell anywhere. I saw no evidence of it."

The WTU has what it calls a leadership triad in which medical staff and commanders work together to provide the best care for soldiers. Jensen said the command often overruled medical recommendations.

In May 2012, as punishment for the positive drug test, he said, the unit confined him to the barracks, docked his pay, knocked him down in rank and assigned him to 45 days of extra duty — picking weeds and scrubbing toilets.

Jensen said he wept as the commander called him a disgrace to the uniform.

The soldier had lost all his teeth after his second injury. Army doctors had scheduled him to get implants at UCLA Medical Center in May, he said, but the WTU canceled the surgery because he was busy scrubbing toilets. The WTU said in a taped conversation with a veterans advocate provided to The Gazette that the surgery was canceled because Jensen would not stop smoking.

He still has no teeth.